Causes | Physiotherapy for hip impingement syndrome

Causes

The causes of hip impingement can be caused by a change in the formation of the femoral head or the acetabulum from birth. If the femoral head is too large and the angle between the head and neck of the bone is altered, FAI may be favored. Also, if the acetabulum is too deep, the femur will strike the cartilaginous socket more quickly.

This results in impingement.Through strong mechanical stress on the joint, e.g. through extreme straddling or bending (gymnastics, ballet, martial arts), the acetabulum can be constantly irritated by the femoral head. Small changes in the anatomy then have all the stronger effects, injuries and associated accumulation of tissue at the acetabulum can occur, which in turn promotes tightness. Mechanical overloading can result in impingement in the hip.

Test

To diagnose hip impingement there is a provocation test, which is performed by the therapist or the doctor. The patient lies in a supine position on the pad and allows his leg to move passively. The hip joint is simultaneously guided by the examiner into flexion (flexion) and internal rotation.

During this process, the femoral head rotates into the acetabulum at maximum. If a hip impingement exists, this can cause the typical groin pain. The diagnosis is confirmed by imaging techniques.

OP

Since it is a bony constriction that increases the risk of suffering from hip joint arthrosis, there is often an indication for surgery for impingement in the hip. Although symptoms can be partially relieved by conservative therapy, in many cases the existing tightness cannot be eliminated. An operation is necessary.

This operation is usually performed by means of arthroscopy. In this procedure, the joint is not opened completely, but devices are inserted through small holes (minimally invasive). The condition of the joint can be assessed and documented by arthroscopy.

At the same time, torn joint cartilage (often affected by impingement is the labrum – the joint lip), bony attachments that narrow the space can be sutured or removed. Bony deformations of the socket and femoral head can also be removed during arthroscopy. After the operation, the patient should be able to move freely and painlessly again. Depending on the physician’s instructions, immobilization or post-operative treatment can be arranged individually.